Expect A LOT More of This With The New Federal Health Care Rules

Via the Dallas Morning News:

A last-minute change in the federal health care bill ditched a proposed 5 percent tax on cosmetic medical procedures and replaced it with a 10 percent tax on indoor tanning services.

Goodbye Botox tax. Hello tan tax.

This seems really random.  Why should either of these businesses foot a special, disproportionate share of my health care bill?  Well, things that seem random to most of us make perfect sense in Congress.

The tan tax popped up in the health care bill last weekend after powerful medical lobbies "“ including the American Academy of Dermatology Association, American Medical Association, American Society of Plastic Surgeons and Botox-maker Allergan "“ persuaded Congress to remove a tax on cosmetic medical procedures and replace it with a 10 percent surcharge on indoor tanning services.

Lobbyists are very good at punching political hot-buttons.  Since they couldn't argue that botox is "for the children," and since it is generally used by rich white people they could not place the race or class card, they played the only card they had:

"Since 90 percent of cosmetic surgery patients are women, this would have been a very discriminatory tax," said White, who opposed the cosmetic surgery tax.

Technocrats want to believe, and perhaps honestly believe themselves, that care guidelines in the new Federal health care system will be science-based.  What possible basis do they have for thinking that?  We have 50 state laboratories, where states specify must-carry rules on procedures, and not a single one of these lists are science based -- they are loaded with special interest handouts.   I even show in this post how special interests give money to academia to produce studies whose entire conclusion is that certain procedures (performed by the special interest group funding the study) need to be in the minimum coverage laws.   The very first time out, when confronted with a science-based care recommendation (that women not receive breast cancer screening until after 50), the Congress specifically overrode it in the bill under a firestorm of public outcry.

But maybe the dermatologist guys are really looking after us?  After all:

The American Academy of Dermatology warns of significant health risks caused by indoor tanning.

But, as it turns out, it only sees health risks in the use of ultra-violet light by practitioners who are not members of their trade group.  I have bolded the key passage that gives away the game.

Indoor tanning industry groups note that dermatologists use tanning equipment in their offices for cosmetic skin conditions, such as eczema and psoriasis, in phototherapy treatments that cost up to $100 per visit billed to health insurance companies. In contrast, indoor tanning salons cost as little as $6 to $20 per session.

The tan tax would exempt phototherapy services performed by a licensed medical professional.

"This is like Coke being allowed to lobby the government to tax Pepsi, but that Coke be allowed to sell the same product and not be taxed for it," International Smart Tan Network Vice President Joseph Levy said in a statement. "It's unbelievable."


  1. nicole:

    Gee, I wonder what percentage of people who go tanning are women. This fails even their piss poor test of logic. We are so unbelievably screwed by this whole "reform" I can hardly believe it's actually happening.

  2. perlhaqr:

    Sadly, Mr. Levy, this is in fact remarkably believable.

  3. Michael:

    “Since 90 percent of cosmetic surgery patients are women, this would have been a very discriminatory tax,” said White, who opposed the cosmetic surgery tax.

    These are older moneyed white women that vote. I'd bet the majority of tanning bed users are younger white women who don't vote.

  4. ilovebenefits:

    What do you think tanning bed organizations will do? Perhaps be run under the supervision of a Dermotologist? Just like the excise tax revenues will never be realized. We will simply skinny down the coverage provided by the plan to stay under the ceiling. The costs of what is no longer covered will be passed on to plan participants... who will either pay for the services out of their pocket or avoid the services altogether.

    Only the unions who have contracts will force the employers to pay the bill, or the federal government who will force tax payers to pick up the bill. http://www.healthexpertease.org

  5. ADiff:

    While a case can be made for positive benefits of tanning booths (after all, vitamin D deficiency is a problem, not in small part due to the exaggerated impact of government led propaganda about the legitimate dangers of sunlight). But I'm not at all sure any case can be made for any socially beneficial impact from Botox. Not that it's particularly relevant to the negative economic (and probably social) impacts of any tax, but it's interesting government chooses to discourage the one of the two that at least in some respects contributes to controlling medical costs by addressing (however inadvertently) a significant chronic health problem.

    To paraphrase Murphy: whatever the government can get wrong, it will get wrong.

  6. GoldenOne:

    Phototherapy is NOT the same as tanning. Most phototherapy done today is NarrowBand UVB which does not tan but does help put many skin diseases into a controllable state or remission. NB-UVB is also safer they tanning because it has 0% increased risk of cancer unlike tanning systems. While I may not agree with the tax in the first place I do agree that the medical side of light therapy should not be taxed.
    It you have had to suffer with Psoriasis, Vitiligo or another skin disease then you'd understand the difference and that a Tanning bed is NOT Phototherapy.
    Phototherapy is one of the most effective and Safest ways to treat skin diseases and the only side effect is a possible mild burn vs. the long list of side effects that biologic medications have including cancer and death. If you want more info go the National Psoriasis Foundation's site http://www.psoriasis.org.

  7. Methinks:

    But I’m not at all sure any case can be made for any socially beneficial impact from Botox.

    Beautification of the planet's population?

    Cosmetic procedures are the most lucrative area of medicine. It's why my otolaryngologist started doing nose jobs and why dentists all try to drum up cosmetic dentistry business. Like Goldman, they're doing God's work, you know.

  8. Craig:

    It's also important to note that our representatives are huge consumers of Botox.

  9. markm:

    So much for taxing the rich...